MEDICARE: DR. JANICE L MCDONALD DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	JM008638	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MI4161002	OTHER	MI	MEDICARE PTAN
3	N27530074	OTHER	MI	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508861717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE L MCDONALD DO

Provider Business Mailing Address
First Line	:	PO BOX 1847
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49443-1847
Country	:	US
Telephone Number	:	231-727-4444
Fax Number	:	231-727-4451

Provider Business Practice Location Address
First Line	:	1675 LEAHY ST
Second Line	:	SUITE 428
City	:	MUSKEGON
State	:	MI
Zip	:	49442-5500
Country	:	US
Telephone Number	:	231-672-3300
Fax Number	:	231-672-3380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/11/2016

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Directions to “ DR. JANICE L MCDONALD DO” Practice Location

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